The Quality of Trabecular Bone Tissue in Women with Rheumatoid Arthritis

V.V. Povoroznyuk, T.A. Karasevska, N.I. Dzerovych


The article deals with the study of the quality index of trabecular bone tissue in patients with rheumatoid arthritis (RA). The study included 134 female patients with RA aged 31 to 78 years (mean age — 52.4 ± 12.7 years; height — 162.6 ± 6.4 cm; weight — 68.5 ± 13.8 kg; average duration of disease — 9.1 ± 7.6 years). In studying the effect of age on the structural and functional state of bone tissue, the examined patients were divided into five groups by decades. In order to evaluate the effect of glucocorticoids (GC) on the parameter of quality of trabecular bone and bone mineral density (BMD), the patients were divided into three groups: 1st group comprised 37 patients who did not take GC, 2nd group — 47 patients who had been prescribed with GC only at exacerbation, of the short, less than 6 months term, 3rd group — 50 patients who received systemically GC at a dose of ≥ 5 mg by prednisone for over 3 years. By the method of dual energy X-ray densitometry (Prodigy, GE Lunar, Madison, USA) we measured BMD at the lumbar spine, proximal femoral and radial bone. The index of the quality of trabecular bone tissue (TBS) of the lumbar spine was determined using the method of TBS iNsight (Med-Imaps, Pessac, France). It is established that starting from the age of 50 years, the indices of TBS L1-L4 (1.156 ± 0.140 vs. 1.318 ± 0.155 in women aged 30–39 years; t = 3.5; p = 0.001) and BMD of different parts of the skeleton in women with RA are significantly decreasing. GC administration is associated with the violation of the quality of the bone tissue. It was revealed that at the systemic administration of GC (in the 3rd group compared to the 1st group), rate of TBS L1-L4 (1.147 ± 0.168 vs 1.250 ± 0.135; t = –3.07; p = 0.003) was significantly lower, while significant changes in BMD parameters of the lumbar spine and femur hadn’t been detected. Over the year of follow-up the index TBS L1-L4 in 1st group decreased by 1.4 %, in 3rd group — by 5.8 %. Thus, the definition of TBS L1-L4 is a technique that can assess the impact of GC on bone tissue and dynamics of its loss as a result of treatment.


bone tossue quality (TBS L1-L4); rheumatoid arthritis; glucocorticoids; bone mineral density; osteoporosis


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